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		<title>新增报修</title>
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        <h1 class="title" style="font-family: '微软雅黑';">新增报修</h1>
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                <!-- Text inputs -->
                <li>
                    <div class="item-inner" style=" margin-left: 0px; padding: 0 14px; border-bottom: 1px solid #efefef;">
                        <div class="item-title label titles">姓&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;名：</div>
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                            <input type="text" placeholder="姓名" name="applicant" id="applicant" style="font-size: 14px;" disabled="true"/>
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                            <input type="text" placeholder="手机号" name="telphone" id="telphone" style="font-size: 14px;" disabled="true"/>
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                        <div class="item-title label titles">楼栋｜门牌：</div>
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                            <div class="item-title label titles">类&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;别：</div>
                            <div class="item-input" style="width: 20%;">
                                <select name="subdistrictsid" id="subdistrictsid">
                                    <option value="">请选择</option>
                                    <option value="水电">水电</option>
                                    <option value="煤气">煤气</option>
                                    <option value="安防">安防</option>
                                    <option value="其他">其他</option>
                                </select>

                            </div>
                        </div>
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                </li>

                <li>
                    <div class="item-inner" style=" margin-left: 0px; padding: 0px 14px;">
                        <div class="item-title label titles">事&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;由：</div>
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